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Revised
Form IBR-1
2019
Business Registration Form
Register online at:
business.idaho.gov/forms
Fax to: (208) 334-5364

IDAHO BUSINESS REGISTRATION SHADED AREAS FOR STATE USE ONLY
Return to: PO BOX 36 Account Number Confirmation No.
BOISE, ID 83722-0410

1. Type of business (see instructions) 1a. If LLC, how have you chosen to be
taxed for income tax purposes?
Corporation Partnership S Corporation Sole Proprietorship Single Member Corporation
Nonprofit Government Fiduciary/Trust Limited Liability Company Partnership S Corporation
2. Purpose of registration
New applicant Change legal name Change assumed business name (DBA)
Add new account type Add/change location Change in partners, shareholders or managing members %
3. Apply for permits/accounts
Boise Auditorium Idaho Falls Auditorium Pocatello/Chubbuck Auditorium E911 Prepaid Wireless Fee
Sales Marketplace Facilitator Out-of-State Retailer Use Travel & Convention
Unemployment Withholding Withholding only, no employees working in Idaho
Request more information
Amusement Device Beer/Wine Cigarette/Tobacco
4. Federal Employer Identification Number (EIN) 5. Social Security number (SSN) 6. Legal business name (see instructions)
Name on SSN card for Sole Prop

7. Assumed business name (DBA) Filed with Sec of State 8. Date incorporated 9. State incorporated in 10. Month tax year ends

11. Date business began in Idaho 12. Date sales or use will begin in Idaho 13. Estimated monthly taxable sales

month year
14. Physical location of business if outside Idaho (no PO Box or mail drop addresses)
Street address City State County ZIP Code

15. Required: Physical location of Idaho employees or the lodging facility address (no PO Box or mail drop addresses)
Street address City State County ZIP Code

16. Mailing address
Street address or PO Box City State County ZIP Code

17. Mailing for Idaho State Tax Commission forms
Street address or PO Box City State County ZIP Code

18. Business telephone number 19. Business contact person (name, title, and email) (See instructions for definitions.) POA will be required.
( )
20. Telephone number & extension of authorized contact person 21. Email address of authorized contact person 22. Fax number of authorized contact
person
( ) ( )
23. Primary nature of business: (Specify the product manufactured and/or sold or the type of service performed.)

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Form IBR-1 Business Registration Form Revised 2019
24. Have you ever had a withholding, sales, use, workers’ compensation or unemployment insurance number in Idaho? If yes, list all permit,
account or policy numbers. (It is your responsibility to cancel any existing accounts you no longer need. Failure to provide previous
account/policy numbers could result in delays and/or duplicate accounts.)

25. Are you a Professional Employer Organization (PEO)? .................................................................... Yes No
If Yes, Name
26. If Yes, are you a Certified PEO? ........................................................................................................Yes No
27. Are you an employer joining a Professional Employer Organization? ............................................... Yes No
Name of PEO

28. Are you an employer leaving a Professional Employer Organization? .............................................. Yes No
Name of PEO

29. Are you a Common Paymaster? ....................................................................................................... Yes No
If Yes, Name
30. Are you an employer joining a Common Paymaster? ....................................................................... Yes No
Name of Common Paymaster
31. Are you an employer leaving a Common Paymaster? ...................................................................... Yes No
Name of Common Paymaster

32. Are you a IRS 3504 Pay Agent? ......................................................................................................... Yes No
If Yes, Name
33. Are you an employer joining a IRS 3504 Pay Agent? ........................................................................ Yes No
Name of Common IRS 3504 Pay Agent
34. Are you an employer leaving a IRS 3504 Pay Agent? ....................................................................... Yes No
Name of Common IRS 3504 Pay Agent

35. List (a) owner and spouse of sole proprietorship, ( )ball partners of partnership, (c) all corporate officers of corporation, (d) trustee or
responsible party of fiduciary or trust, or (e) all members of limited liability companies. Social Security number required for every individual
listed. (Use additional sheet if necessary.)
Name Address of Residence SSN/EIN, Phone Number and Email Corp Title % Director? Compensated?
Owned Yes/No Yes/No
select select
NoYes NoYes
Officer Shareholder
select select
NoYes NoYes
Officer Shareholder
select select
NoYes NoYes
Officer Shareholder
CERTIFICATION: I certify that I am authorized as an owner, partner, corporate officer, member or representative to sign this document and
that the statements made are correct and true to the best of my knowledge. (This form must also be signed by the spouse of a sole proprietor.)
Print name Signature Date
Print name Signature Date
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Form IBR-1 Business Registration Form Revised 2019
36.Date employees first hired to work in Idaho 37. Date of employees’ firstpaycheck in Idaho 38. Expected number of Idaho employees
(Include corporate officers working in Idaho)

39.Enter the amount of wages you have paid or estimate to pay in Idaho. If you haven’t paid or don’t plan to pay wages during one of the
periods listed, enter “NONE.”
Jan. 1 to March 31 April 1 to June 30 July 1 to Sept. 30 Oct. 1 to Dec. 31
Current
Year
Preceding
Year
40. If you estimated wages in #39, enter the date you plan to begin paying wages.

41. Will corporate officers receive compensation, salary or distribution of profits?Yes No

42. Is this an organization exempt from income tax under Internal Revenue Service Code 501(c)(3)? Yes No

43. Is workers’ compensation insurance needed? (see instructions) Yes No, explain why:
CAUTION: This is not an application for workers’ compensation insurance
44. Do you have a workers’ compensation 45. Have you notified your insurance company that 46. Insurance agent’s name and
insurance policy? you have or expect to have Idaho payroll? telephone number

Yes No In process Yes No ( )
47. Insurance company name 48. Policy number 49. Effective date 50. If applying for insurance with the Idaho State Insurance Fund,
list application number:

51. Do you plan to perform work in other states using your existing Idaho employees? Yes No
If Yes, will you withhold Idaho Income Tax? select
NoYes
ACQUIRING AN EXISTING BUSINESS OR CHANGING TYPE OF LEGAL BUSINESS ENTITY
If you buy an existing business, or change your business entity, Idaho law requires you to withhold enough of the purchase money to pay any
sales tax and, in most cases, unemployment insurance due or unpaid by the previous owner/entity until the previous owner/entity produces
a receipt from the Idaho Department of Labor and the Idaho State Tax Commission showing the taxes have been paid. If you fail to withhold
the required purchase money and the taxes remain due and unpaid after the business is sold or converted to another entity type, you may be
liable for the payment of the taxes collected or unpaid by the former owner/entity. When there is a change in the legal entity, you must notify
your workers’ compensation insurance company.
52. Did you acquire all or part of an existing business? 53. Did you change your legal business entity?
All Part None Yes No
54. Previous owner’s name 55. Business name at time of purchase

56. Date acquired/changed 57. Account/permit numbers of the business acquired/changed 58. Was there a change in owners, members, or partners?
Yes No
If Yes, are any of the former owners, members, or
partners still operating/managing the business for the
new owner(s)?
Yes No
If No, is the owner of the new business ALSO a former
employee of the old business who had authority to
make financial or hiring/firing decisions?
Yes No

PUBLICATION CONSENT
59. Yes, I agree to publish my business by category both in print and on the Internet in the Business Director of Idaho at Iml.idaho.gov and
any publication produced by the Idaho Department of Labor. This will increase visibility of my business to a larger pool of job applicants,
will allow my business to be included when the Department of Labor responds to questions about the availability of products and services
in the community, and expand the opportunity for additional sales. I acknowledge the Idaho Department of Labor’s files will be accessed to
obtain my company name, address, phone number, NAICS (industry) code and range of employment.
Signature
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Revised
Form IBR-1 — Instructions
2019
Business Registration Form

For faster service, you can register online at: business.idaho.gov
For more help, contact:
Idaho Department of Labor – (208) 332-3576 in the Boise area or toll free at (800) 448-2977
Idaho Industrial Commission – (208) 334-6000 in the Boise area or toll free at (800) 950-2110
Idaho State Tax Commission – (208) 334-7660 in the Boise area or toll free at (800) 972-7660

All information must be provided or your registration can’t be processed.
Instructions are provided only for items that may need clarification.

1. Mark the type of legal business entity. If you 3. Mark the type of permits or accounts you would like
have questions about types of legal business to apply for:
entities, contact the Idaho Secretary of State,
• Employees. Mark Unemployment and
(208) 334-2300.
Wthholding.
1a. Mark the correct box to indicate how the Limited • Retail sales. Mark Sales.
Liability Company has chosen to be taxed for income • Indicate if you are a Marketplace Facilitator
tax purposes. or Out-of-State Retailer. Separate permits
2. Mark the item(s) that best describes your purpose in are required.
filing this form: • Renting rooms for 30 days or less. Mark
Sales and Travel and Convention.
New applicant. If the business is not currently
registered with the Idaho State Tax Commission, • Renting rooms in an Auditorium District
the Idaho Industrial Commission, or the Idaho for 30 days or less. Mark the appropriate
Department of Labor. auditorium district these rooms are located in.
• Using, consuming, or storing items in
Change legal name. If the business is changing its Idaho on which you have not paid sales tax.
legal name, include a copy of proof, i.e. amended Mark Use.
articles of incorporation or federal documentation.
• Withholding only. Mark the box if you have
Change assumed business name. If the business no employees physically working in Idaho, but
is changing its assumed business name (DBA). you wish to withhold Idaho income tax as a
convenience to an employee whose income
Add new account type. If you already have one of is taxable in Idaho, even though it is earned in
the permits listed on the application and now need another state. Complete all applicable questions
another permit. (Example: You have a sales permit through line 34.
and now need a withholding and/or unemployment • Selling prepaid wireless service. Mark E911
account.) Prepaid Wireless Fee.
Add/change location. If the business has changed Mark the type of permits or accounts you would like
its physical business location or added other additional information for:
locations. • Operating currency or coin-operated
machines used for amusement. For example:
Change in partners, shareholders, or managing video games or juke box. Mark Amusement
members. List the percentage of change if Device.
the business has new or additional partners,
• Producing or wholesaling beer. Producing,
shareholders, or managing members. Be sure to
distributing, or direct shipping wine. Mark
list all of the partners, shareholders, or managing
Beer/Wine.
members in box 24.
• Wholesaling, distributing, subjobbing, or
Regardless of your purpose in filing this form, the delivery selling of cigarettes or tobacco.
following boxes must be completed: 1, 2, 3, 4 or Mark Cigarette/Tobacco.
5, 6, 10, 11, 14, 15, 17, 18, 19, 22, and 24. You can find a permit application for amusement
devices, beer, wine, cigarette, and tobacco at
tax.idaho.gov, or contact the Tax Commission.

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Form IBR-1 Business Registration Form Instructions (continued) Revised 2019

4. List your federal Employer Identification Number 18-22. You are authorizing the agencies with which
(EIN) if one has been issued to you by the Internal you register to contact the named individual to
Revenue Service. If you have employees, or the discuss issues relating to your accounts. In some
business is other than a sole proprietorship, you cases, there may be additional Power of Attorney
must have a federal EIN. If you have applied requirements.
for your EIN, but have not received it yet, enter
“applied for.” If you are not required to have an 23. Describe in detail the products and/or services
EIN, leave this box blank. your business in Idaho will provide. (Example:
Retail sales: clothing, food. Agricultural crops:
5. Enter your Social Security number if the type of corn, beets. General Contractor: building single-
business entity is a sole proprietorship. family homes.)

6. List the legal name of the business. If the 24. If this business entity or its owner, partners or
business is owned by a sole proprietor, list the members has ever had a withholding, sales,
name shown on the owner’s Social Security card. use, workers’ compensation or unemployment
If the business is owned by a corporation, limited insurance number in Idaho, list all permits,
liability company or partnership, list the legal name accounts, or policy numbers.
as registered with the Secretary of State.
35. List the appropriate information:
7. List the assumed business name (DBA), if different If you marked government on number 1, line 24 is
than the legal business name. (Example: Legal optional.
name Karan Jones - DBA Karan’s Flowers.) This (a) If you marked Sole Proprietorship on number
name must also be registered with the Secretary of 1, list the requested information for the owner
State, (208) 334-2301. and spouse.
8. If your business is a corporation, enter the date (b) If you marked Partnership on number 1, list
incorporated. the requested information for each partner.
If the partner is an individual, list the Social
9. If your business is a corporation, enter the state in Security number. If the partner is another
which it was incorporated. business entity, list the EIN. If there are more
than three partners, include an additional
10. If the business files income tax returns on a page listing them.
calendar year basis, enter December. If the
business files income tax returns on a fiscal year (c) If you marked S Corporation, Corporation,
basis, enter the month the business’ fiscal year or Nonprofit on line 1, list the requested
ends. information for each officer. Indicate if the
officer is on the board of directors by writing
11. Enter the date this business began operating in “yes,” “no,” or “not applicable” (NA). If there
Idaho. are more than three officers, include an
13. Estimate the highest amount of taxable sales the additional page listing them.
business will have in any month. (d) If you marked Fiduciary/Trust, list the trustees
or responsible parties. If there are more than
14. List the business’ physical location in Idaho. If you three trustees or responsible parties, include
have more than one location, include a separate an additional page listing them.
page listing the additional locations. (e) If you marked Limited Liability Company on
(Don’t use a PO Box or mail drop address.) number 1, list the requested information for
15. List the physical location where employees will all members. If there are more than three
perform work or the lodging facility where the members, include an additional page listing
accommodations are located. them.
41. The Internal Revenue Service grants or denies
17. If you wish to have the Idaho State Tax 501(c)(3) status. The granting of this status
Commission report forms mailed to an address doesn’t exempt a business from unemployment
different than the one listed on line 15 (such as insurance tax, sales tax, withholding or workers’
your accountant’s address), list that address. compensation insurance.
42. The Idaho Department of Labor offers businesses
granted 501(c)(3) status three methods for paying
state unemployment insurance tax liabilities.

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Form IBR-1 Business Registration Form Instructions (continued) Revised 2019

32-43. If hiring one or more full-time, part-time, seasonal, 50. If you have applied for insurance with the State
or occasional workers, Idaho law requires that you Insurance Fund, list the application identification
obtain a workers’ compensation insurance policy number.
prior to hiring employees unless you are exempt.
A minimum penalty of $25.00 per day can be 52-57. If your business is reorganizing (i.e. you have
assessed against employers who operate wtihout formed a corporation which has acquired your sole
workers’ compensation insurance. proprietorship), then you are acquiring an existing
business.
THIS IS NOT AN APPLICATION FOR
INSURANCE. YOU WILL NEED TO CONTACT 59. Data is maintained by the Idaho Department of
YOUR INSURANCE AGENT OR COMPANY Labor. Data can consist of name, address, phone
REPRESENTATIVE FOR ASSISTANCE. number, and NAICS (industry) code. Employment
If you answer no to this question, explain in detail figures are published in predetermined size
why you believe workers’ compensation insurance ranges. Exact employment figures are not
is not needed for your business. (Include published.
additional page if necessary.)
If your business is reorganizing, you must notify
your workers’ compensation insurance carrier of
the new type of business, including EIN numbers,
if applicable.
If additional assistance is needed, contact
the Idaho Industrial Commission Compliance
Division, (208) 334-6000 or by email at
suretyrequest@iic.idaho.gov.

44-49. If you already have obtained a workers’
compensation insurance policy, please complete
boxes 46 through 49.
If you are in the process of obtaining a workers’
compensation insurance policy, complete boxes 46
and 47.

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